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产后六个月时的母亲抑郁与母亲的情感可及性:来自慈善机构怀孕与情绪健康研究(MPEWS)怀孕队列的研究结果。

Maternal depression and the emotional availability of mothers at six months postpartum: Findings from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) pregnancy cohort.

作者信息

MacMillan Kelli K, Lewis Andrew J, Watson Stuart J, Galbally Megan

机构信息

Psychology Discipline, Murdoch University, Perth, Australia.

Psychology Discipline, Murdoch University, Perth, Australia; School of Medicine, The University of Notre Dame, Fremantle, Australia.

出版信息

J Affect Disord. 2020 Apr 1;266:678-685. doi: 10.1016/j.jad.2020.01.109. Epub 2020 Jan 21.

DOI:10.1016/j.jad.2020.01.109
PMID:32056944
Abstract

BACKGROUND

Existing research suggests maternal depression may reduce the quality of early mother-infant interaction and this might increase our understanding of how maternal mental health impacts on child development outcomes. However, most studies recruit from community samples and few include both a diagnostic measure of maternal depression together with an observational measure of the quality of the mother-infant relationship.

METHODS

Data was drawn from 210 women recruited in early pregnancy until 6 months postpartum within an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Those women who at six months postpartum were video recorded interacting with their infant for at least 40-minutes were included in this study, with the quality of those interactions assessed using the Emotional Availability Scales coding system. Depression was measured using the Structured Clinical Interview for the DSM-IV-TR Clinician Version and the Edinburgh Postnatal Depression Scale, and covariates included maternal age and education.

RESULTS

Whilst results showed a small negative association between antenatal depressive symptoms in trimester one of pregnancy and maternal EA, there was no effect of maternal depression diagnosis or of maternal depressive symptoms in later pregnancy or postpartum.

LIMITATIONS

This study focuses exclusively on mothers and does not account for the role of partners.

CONCLUSIONS

Maternal depression might have a smaller effect on maternal EA then some existing research implies, with that effect most prevalent in early pregnancy. Clinical intervention might not be necessary for all mother-infant dyads experiencing depressive symptomology, but instead be directed to those with additional risk factors.

摘要

背景

现有研究表明,母亲抑郁可能会降低早期母婴互动的质量,这可能会增进我们对母亲心理健康如何影响儿童发育结果的理解。然而,大多数研究是从社区样本中招募的,很少有研究同时包括母亲抑郁的诊断测量和母婴关系质量的观察测量。

方法

数据来自澳大利亚一个怀孕队列“梅西怀孕与情绪健康研究”中招募的210名女性,从怀孕早期到产后6个月。本研究纳入了那些在产后6个月与婴儿互动至少40分钟并被录像的女性,使用情感可及性量表编码系统评估这些互动的质量。使用《精神疾病诊断与统计手册》第四版修订版临床医生版本的结构化临床访谈和爱丁堡产后抑郁量表测量抑郁,协变量包括母亲年龄和教育程度。

结果

虽然结果显示怀孕第一阶段的产前抑郁症状与母亲的情感可及性之间存在小的负相关,但母亲抑郁诊断或怀孕后期或产后的母亲抑郁症状没有影响。

局限性

本研究仅关注母亲,没有考虑伴侣的作用。

结论

母亲抑郁对母亲情感可及性的影响可能比一些现有研究所暗示的要小,且这种影响在怀孕早期最为普遍。对于所有有抑郁症状的母婴二元组,可能并非都需要临床干预,而是应针对那些有额外风险因素的母婴二元组。

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